Abstract 16804: Incidence of Sudden Cardiac Death After Ventricular Fibrillation Complicating Acute Myocardial Infarction
Background: No data exists on long-term prognosis or causes-of-death analysis among survivors of acute myocardial infarction (MI) according to whether or not they developed ventricular fibrillation (VF) during the acute stage of MI.
Hypothesis: Incidence of sudden cardiac death (SCD), during follow-up, is higher in patients who developed VF during the acute stage of MI compared to those who did not experience VF.
Methods and Results: Among 3,670 MI patients hospitalized in France in 2005 and enrolled in this prospective cohort study, we assessed in-hospital mortality and 5-year cause of death among those who survived to hospital discharge, according to whether they developed VF (116 cases) or not, during the acute stage. 94.5% of patients had complete follow-up at 5 years. In-hospital mortality was significantly higher among VF patients (adjusted OR 7.82, 95% CI 4.60-13.3, P <0.001). Among 3,463 survivors at hospital discharge, 1,024 died during a mean follow-up of 52±2 months. The overall survival rate at 5 years was 74.4% (95% CI 72.8-76.0). In Cox multivariate analysis, occurrence of VF during the acute phase of MI was not associated with an increased mortality at 5 years (HR 0.7, 95% CI 0.3-1.3, P=0.21). The distribution of causes of death at 5 years did not statistically differ according to presence or absence of VF, especially for sudden cardiac death (SCD) (13.1% in VF group vs.12.9% in non-VF group), despite a very low rate of implantation of cardioverter defibrillator in both groups (overall rate 1.2%).
Conclusions: Patients developing VF in the setting of acute MI are at higher risk of in-hospital mortality. Beyond the acute phase, however, VF is not associated with a higher long-term all-cause or SCD mortality.
- Myocardial infarction
- Ventricular fibrillation
- Implantable cardioconvert defibrillator
- Sudden cardiac death
- © 2013 by American Heart Association, Inc.